Treatment Outcome of Oral Leukoplakia with Er:YAG Laser: A 5-Year Follow-Up Prospective Comparative Study.

OBJECTIVE: The purpose of this prospective analysis was to evaluate the efficacy of erbium-substituted yttrium aluminum garnet (Er:YAG) laser compared with that of conventional surgery, regarding the long-term outcome of nondysplastic oral leukoplakias (OL).

BACKGROUND: To date, this comparison has never been performed.

METHODS: Patients were randomly allocated to two different groups: some underwent surgical excision with traditional scalpel (Group TrSc) and others underwent an ablative session with Er:YAG laser (Group Las), with these modalities: 1.5-W power, 150-mJ pulse energy, 10-Hz frequency, 500-μs pulse duration, and 0.9-mm spot size. During the follow-up period, the evolution of the OL was listed as (1) healing: if novel lesions did not appear in the same place of the surgery and (2) recurrence: if a new mucosal change has been detailed in the equivalent place of the primary disease.

RESULTS: One hundred seventeen lesions were treated. Fifty-eight lesions underwent surgery with traditional scalpel, whereas 59 underwent laser surgery. Follow-up ranged from 24 to 108 months (median of 58). Healing was detailed for 52.99% (n = 62) of the 117 OL, with no statistical differences between the two randomized groups.

CONCLUSIONS: It seems reasonable to consider the Er:YAG laser as effective as traditional scalpel in terms of healing for OL, with the same rate of recurrences in a period of almost 5 years.